The influence of cross-regional medical treatment on total medical expenses, medical insurance payments, and out-of-pocket expenses of patients with malignant tumors in Chinese low-income areas

Abstract

Background In recent years, due to the increasing number of cross-regional medical patients, countries around the world have issued a series of policies or regulations to reduce their out-of-pocket burden. In this context, this study intended to explore the impact of the Spatio-temporal characteristics of cross-regional medical treatment on total medical expenses, medical insurance payments, and out-of-pocket expenses of patients with malignant tumors in low-income areas. Methods This study included 54,904 data of cross-provincial medical treatment of malignant tumor patients insured in Heilongjiang Province, China in 2020. Firstly, Microsoft Excel 2019 and ArcGIS 10.2 were applied to conduct a descriptive analysis of the Spatio-temporal characteristics of their cross-provincial medical treatment. Then, binary and multivariate logistic regression models were used to explore the specific impact of economic level and geographical distance of medical regions on total medical expenses, medical insurance payments, and out-of-pocket expenses. Results The number of cross-regional medical patients showed a gradual upward trend from February to December, and fell back in January. They were concentrated in regions with high economic level and short distance from the insured region, where were more likely to form the group with high out-of-pocket expenses (AOR = 3.620, P < 0.001; AOR = 1.882, P < 0.001). While this possibility in middle-distance medical regions were less (AOR = 0.545, P < 0.001). Afterwards, two sensitivity analysis methods showed that the results were robust. Conclusion The number of cross-regional medical patients with malignant tumors in low-income areas is affected by seasonal factors, meanwhile, their total medical expenses, actual medical insurance payment levels, and out-of-pocket expenses are all affected by the economic level and geographical distance of medical regions. And the middle-distance medical regions may be the best choice for patients with planned cross-regional medical treatment. These provide some evidence for policymakers to improve the fairness and sustainability of medical security for cross-regional medical patients and reduce their direct economic burden of disease.

A cross-sectional survey of first-aid kit equipment in a family in Sichuan, China

“…Respondents who had health insurance were more likely to have a home first-aid kit than those who paid for their own medical expenses. It has been found that differences in medical expenses payment methods reflect differences in the medical care level received [ 14 ]. Respondents without health insurance were likely to be financially disadvantaged and have relatively low incomes, therefore being less likely to have a home first-aid kit.…”

The cross-regional settlement methods in hospitals and the treatment-seeking behavior of patients with malignant tumors in China: an evolutionary game model

“…The uneven geographical distribution of healthcare resources is a major factor driving the increase in the number of patients opting for medical services in various locations ( 4 ). The scope of insurance coverage varies between insured and uninsured areas, with the insured areas encompassing entities such as countries, cities, and other administrative regions ( 5 ). For instance, within the European Union (EU), each member state typically has its own insurance coverage zone.…”

Analysis of the current status and influencing factors of cross-regional hospitalization services utilization by basic medical insurance participants in China − taking a central province as an example

“…In China, cross-regional treatment of patients usually refers to the medical behavior of the population insured by basic medical insurance and whose medical treatment location does not coincide with where they are insured ( 6 , 7 ), including three levels: cross-county, cross-city and cross-province ( 8 ).Many countries such as Germany, the United Kingdom and Japan, have established government/compulsory health insurance coverage covering nearly the whole population ( 9 ). Similarly, China has also established a basic medical insurance scheme covering more than 95% of the population ( 10 ), including two main categories: Urban Employees’ Basic Medical Insurance (UEBMI) and Urban and Rural Residents’ Basic Medical Insurance (URRBMI).…”

“…Only several studies were identified researching the utilization of cross-regional hospitalization services. On the one hand, they focused on analyzing the utilization of cross-regional hospitalization services by patients diagnosed with a specific disease such as tumor ( 6 , 8 , 12 ), rare diseases ( 13 ), and non-emergency hip arthroplasty ( 14 ); on the other hand, they were only restricted to one certain aspect of cross-regional hospitalization service utilization, such as the choice of medical institution level ( 14 , 15 ), hospitalization expenses and deductibles ( 16 ). However, rare research was found analyzing the utilization of cross-regional hospitalization services for patients insured by basic medical insurance from a more comprehensive perspective.…”